Management of chylous leakage after breast surgery: report of four cases.

Chylous leakage is a rare occurrence after breast surgery. Trauma to the thoracic duct and its main distribution may be the main cause of chylous leakage, but the cause of such an injury during breast surgery is unknown. We herein report the first case of chylous leakage from many minimal lymph ducts in a skin flap. In all, four cases of chylous leakage were observed out of 1 096 breast cancer patients who underwent axillary lymph node dissection. Of these four cases, three cases were successfully treated conservatively; however, surgical exploration was performed in the fourth case because of the large drainage volume. Furthermore, we reviewed the recently published studies on chylous leakage after breast surgery; 20 cases (our 4 cases included) have been reported in all. Of the 20 pooled cases, most were cured with conservative treatment and only three cases were cured with surgical treatment.